Rising Star Holdings LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

RISING STAR HOLDINGS LLC

Doing business as

San Diego Pharmacy

Practice address

508 E Gravis St
San Diego, TX 78384-2708

Phone

(361) 209-8322

Fax

(361) 209-5022

NPI assigned

Dec 27, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nandana Kavuri

Title

Officer

Phone

(214) 620-7220

Specialties & licenses 2

Addresses

Other names 1

• San Diego Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tarun Krishna Krothapalli, RPH

  • Pharmacist
  • San Diego, TX
  • NPI 1518567619
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1942772272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1488",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750191488",
            "telephone_number": "361-209-8322",
            "fax_number": "361-209-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 E GRAVIS ST",
            "city": "SAN DIEGO",
            "state": "TX",
            "postal_code": "783842708",
            "telephone_number": "361-209-8322",
            "fax_number": "361-209-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISING STAR HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-27",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "KAVURI",
        "authorized_official_first_name": "NANDANA",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "214-620-7220"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Diego Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in San Diego, TX
• Providers in San Diego, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.